Obesity and Hypertension (Week 12) Flashcards
(25 cards)
Key messages for people living with obesity
Focus on co-morbid problems first and how nutrition will help that
* focus on improving food quality
What are some changes that can be suggested to imrpove eating habits?
- mindful eating
- Eating at home
- Wary of food marketing
- Eat protein foods
- Water choice beverage
- Eating more fruits and veggies
- Understand hunger cues
- Enjoy cultural foods
Anthropometric measurements to take for obesity
Assess degree of overweight or % body fat (e.g. skin folds, waist hip circumferences, bioelectrical impedance, DXA)
BMI
* Measures degree of overweight/obesity
* No special technical requirements
* Allows measurements over time by different individuals
* better as a screening tool then for individual body comp
WC
* In conjunction with BMI can help assess risk CAD/type 2 diabetes
* >88 for for women
* >102 for men
Obesity risk factors Associated with mortality
- CHD
- atherosclerotic diseases (PVD, CVD)
- Type 2 Diabetes
- sleep apnea
Obesity risk factors
- gynecological
- osteoarthritis
- gallstones
- stress incontinence
- elevated triglycerides
- Other CVD risk factors (e.g hypertension, hypercholesterolemia)
- NAFLD
- PCOS
Obesity treatment planning
Include all information gathered in assessment and in addition:
* Client’s point of view (etiology, desired outcomes)
* Attempt to understand client’s perspective
* Treatment plan agreeable to both (client and health care provider)
* Flexibility, evaluation, modification
FAD diets
Very often are not adequate
* entire food groups omitted
* overall calories not sufficient for micronutrients
* ↑Fat ↓CHO diets: low in vitamin E and A, thiamin, B6, folate, Ca, Mg, Fe, K, and fibre
* Very ↓Fat diets: low in vitamin E, B12, Zn
* May not be medically sound (e.g. very low CHO diet may lead to ketosis)
* Initial weight loss but difficult to maintain
Common FAD diets
- calorie reduced diets
- prepackaged meal plans
- Atkins/ PSMF
- Zone
- South Beach
- Weight watchers
Calories reduced diets
Usually prescribed when weight loss is desired outcome of nutrition counseling
* Reduction in fat and total calories (500-1000kcals/d; 1-2 lbs/wk)
* severely restricting calories for extended time
* Food choices high in fibre
What is PSMF?
protein sparing modified fast
* high protein diet (2-3g/kg) with limited CHO (1-2% w/v max). No dairy, fruits/vegetables or grains, particularly in the initial stages
* Low CHO facilitates a metabolic state of increasing ketosis (not ketoacidosis), rapid weight loss, and appetite suppression, “sparing of lean mass’.
* Goal is to protect lean body stores and promote fat loss of fat mass
* NUTRITIONALLY INCOMPLETE; requires close monitoring of electrolytes, fluid status.
* DEFICIENT in potassium and many other nutrients. Patients have to be medically monitored.
* Rarely utilized due to the dangers related to electrolyte disturbances; risk for cardiac arrythmias.
* Other Fad diets:allow higher amount of CHO
Popular diets at a glance
Obesity and being active
National health messages have shifted from promoting exercise to promoting physical activity
* Health benefits regardless of mode, intensity or duration.
* Overall goal for Canadians to accumulate at least 60 minutes of physical activity every day (in periods of at least 10 minutes each).
obesity behavioural modification
- Generation of permanent change of lifestyle habits
- Decrease, change, or eradicate those habits that have caused or contributed to weight gain
- Self-understanding, monitoring is vital to be aware of habits
What causes hypertension?
Primary or Essential Hypertension
* No obvious cause
* Related to combination of genetics and lifestyle factors (diet)
Secondary Hypertension
* Caused by other medical conditions such as: CVD, DM or renal disease (#1), Endocrine disorders
What is hypertension?
High Blood Pressure
* one of the leading causes of death (largely asymptomatic and may go undiagnosed for years)
* 95% primary/essential hypertension
* 5% secondary hypertension
hypertension diagnosis
DBP is defining feature of increased risk for stroke
Basic lab tests for primary HT
- fasting blood glucose (cardiometabolic disregulation)
- CBC (BP can go up with infection)
- lipid profile (metabolic disregulation)
- serum creatinine with eGFR (renal disease)
- Serum Na, K, Ca (influence BP)
- TSH (indrect impact of BP)
Medication treatment for HTN
- ACE inhibitors
- ARB
- Beta blockers
- thiazide & thiazide like-diuretics
- calcium channel blockers
Know functions
HTN lifestyle treatment
- Physical Activity
- Weight Reduction
- Alcohol Consumption (reduce ox stress to vessels)
- Stress Management (reduce chronic levels of cortisol)
- Diet (Dietary Patterns, Sodium, Potassium)
Diet therapies for HTN
- DASH diet
- MED diet
- Portfolio diet
DASH diet
Very good evidence for prevention and anagement and with meds improved outcomes
* More emphasis on eating foods higher in potassium
* High quality plant based sources
* Healthy fats
* Similar to mediteranean
* Different from CFG where not filled with 1/2 grains + F/V
MED diet
Less evidece for HT alone but CVD prevention
* Emphasis on fish and seafood compared to DASH (omega 3 and healthy fats)
* Anti oxidant and anti inflammatory focused diet (full of polyphenols)
* Makes you think about types of oils consuming as well choosing extra virgin olive oil
* See more commonality with CFG in focusing on plant based diet but CFG does not talk about polyphenols and does not focus on fish intake
* Similar to DASH in that it tries to reduce sodium intake
Diet Comparisons between Diet
Approaches
Diets compared to population actual intake
